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In the Spotlight - UTHealth experts take part in U.S. Surgeon General’s first youth e-cigarette report

Researchers from the Michael & Susan Dell Center for Healthy Living at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health were the senior scientific editors for the first-ever U.S. Surgeon General’s Report on E-Cigarette Use Among Youth and Young Adults, released today.

“We were honored to be chosen as the senior scientific editors of this report,” said Cheryl Perry, PhD, regional dean and Rockwell Distinguished Chair in Society and Health at UTHealth School of Public Health in Austin. “It is important for youth, young adults, parents and policy makers to understand that e-cigarettes are not just harmless water vapor. They have substantial amounts of addictive nicotine and are being marketed to attract a young population.”

In 2012, Perry served in the same role for the U.S. Surgeon General’s Report on Preventing Tobacco Use Among Youth and Young Adults along with Melissa Harrell, PhD, MPH, as senior associate editor. Harrell served as senior scientific editor for the 2016 report and MeLisa Creamer, PhD, MPH, a faculty member at the Michael & Susan Dell Center for Healthy Living, also contributed to both the 2012 and 2016 reports. Steven Kelder, MD, MPH, associate regional dean and co-director of the Michael & Susan Dell Center for Healthy Living, joined the team as a senior scientific editor for the 2016 report.

According to the new report, e-cigarettes are a rapidly emerging and diversified product class. The devices typically deliver nicotine, flavoring and other additives to users via an inhaled aerosol. E-cigarettes are now the most commonly used tobacco product among youth, surpassing conventional cigarettes in 2014. E-cigarette use is also strongly associated with the use of other tobacco products among youth and young adults.

E-cigarette use among 18- to 24-year-olds more than doubled from 2013 to 2014. The use of e-cigarettes by young adults 18- to 24-years old has now surpassed that of adults 25 and older. The use of products containing nicotine is dangerous, particularly to youth, pregnant women and fetuses. Studies have shown nicotine exposure during adolescence can cause addiction and harm the developing adolescent brain. E-cigarette aerosols, which can contain harmful and potentially harmful ingredients, including nicotine, are also dangerous for youth.

E-cigarettes are marketed to youth through flavored products and a wide variety of media channels, similar to approaches that the conventional tobacco industry used to target youth and young adults. The authors of the report recommend action at every level to address e-cigarette use among youth and young adults. These actions could include incorporating e-cigarettes into smoke-free policies, preventing access to e-cigarettes by youth, increasing product prices and regulating e-cigarette marketing.

“First, there is no question that traditional tobacco use is exceedingly harmful to human health. Second, the health consequences of nicotine exposure are different for youth than adults and we should double down on efforts to prevent all tobacco use. Finally, there is much that remains to be known about the type and concentration of other hazardous constituents in e-cigarette aerosol,” said Kelder, who is also the Beth Toby Grossman Distinguished Professor in Spirituality and Healing.

UTHealth researchers have made it a priority to determine the patterns of onset and use of e-cigarettes and other tobacco products among adolescents and young adults in Texas. They have also explored how the products are being marketed to teens.

In 2013, several institutions in The University of Texas System, including UTHealth, were funded by the National Cancer Institute of the National Institutes of Health to form the Tobacco Center of Regulatory Science on Youth and Young Adults (Texas TCORS). The goal of the center is to develop an integrated program of research and training to provide scientific evidence and a career path for regulatory scientists to support U.S. tobacco regulation. The center provides professional training and publishes scientific research on youth and young adult use of nicotine and tobacco products, as well as marketing methods targeted to this population.

UTHealth researchers who are also members of TCORS recently published a study on the link between e-cigarette marketing and teen e-cigarette use. Of the more than 22,000 students surveyed, 20 percent had tried e-cigarettes before and 9 percent were current users. Half of the students who had tried e-cigarettes encountered marketing in retail settings and 40 percent saw messages on the internet.

“Until we know more, e-cigarette safety is speculative. Youth and young adults should not be encouraged to use e-cigarettes and youth should have restricted access,” said Kelder. “This report is a call to action for nationwide awareness of this product, with recommendations to public health and educational agencies to prevent the use of e-cigarettes by youth and young adults. It is also a call to action for researchers to further quantify the health risks associated with using e-cigarettes.”